Pharmacist gets 5 years in prison for $180M insurance fraud scam

A pharmacist working in Mississippi has been sentenced to five years in prison for defrauding Tricare and private insurance companies out of millions, the Department of Justice said Wednesday.

David “Jason” Rutland, of Bolton, paid kickbacks to distributors for prescription referrals that were medically unnecessary, ultimately leading to more than $180 million in fraudulent billings, including more than $50 million paid by federal health programs.

Rutland, 42,  a co-owner of compounding pharmacies, which make medications tailored to specific patient needs, had recruiters secure prescriptions for high-margin meds and paid those individuals commission based on reimbursement rates from pharmacy benefits managers and other programs such as Tricare.

The pharmacist also illegally waived or altered co-payments for beneficiaries to make it seem that his pharmacies had been collecting money all along, the DOJ said.

Rutland pleaded guilty in July 2021 to conspiracy to defraud the U.S. and solicit, receive, offer and pay illegal kickbacks. He has been ordered to give up all money he gained illegally.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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